Yes
RUHS - MC - Retail Pharmacy
26520 Cactus Avenue
Moreno Valley, CA 92555
RUHS - Surgical Center Pharmacy
26600 Cactus Ave
Moreno Valley, CA 92555
RUHS - Corona Pharmacy
2813 South Main Street
Corona, CA 92882
RUHS - Neighborhood Pharmacy
7140 Indiana Ave
Riverside, CA 92504
RUHS - Palm Springs Pharmacy
191 N Sunrise Way
Palm Springs, CA 92262-5201
Details | Last Recertification Date | Update | Recertification | 2/12/2024 3:14:10 PM | 2/20/2025 9:08:46 PM | 2/20/2025 9:08 PM |
Details | Last Recertification Date | Update | Recertification | 2/28/2023 7:41:04 AM | 2/12/2024 3:14:10 PM | 2/12/2024 3:14 PM |
Details | Last Recertification Date | Update | Recertification | | 2/28/2023 7:41:04 AM | 2/28/2023 7:41 AM |
Details | Entity Name | Update | Recertification | Riverside, County of | RIVERSIDE COUNTY HEALTH SYSTEM | 2/28/2023 7:41 AM |
Addresses | Shipping Address | Insert | Change Request | | RUHS - Palm Springs Pharmacy
191 N Sunrise Way
Palm Springs, CA 92262-5201 | 12/7/2022 3:09 PM |
Details | State | Update | | Approved | Active | 10/1/2022 12:01 AM |
Contacts | Signed By | Insert | New Registration | | Patterson, Leah
Chief Nursing Officer
RUHS
9514867532 | 7/25/2022 11:26 AM |
Details | 340B ID | Update | New Registration | | CHC28990-15 | 7/25/2022 11:26 AM |
Dates | Participating Approval Date | Update | New Registration | | 7/25/2022 11:26:29 AM | 7/25/2022 11:26 AM |
Details | State | Update | New Registration | Pending | Approved | 7/25/2022 11:26 AM |
Dates | Signed By Date | Update | New Registration | | 7/20/2022 2:35:12 PM | 7/25/2022 11:26 AM |
Dates | Start Date | Update | New Registration | | 10/1/2022 12:00:00 AM | 7/25/2022 11:26 AM |
Addresses | Main Address | Insert | New Registration | |
191 N Sunrise Way
Palm Springs, CA 92262-5201 | 7/8/2022 4:56 PM |
Addresses | Shipping Address | Insert | New Registration | | RUHS - MC - Retail Pharmacy
26520 Cactus Avenue
Moreno Valley, CA 92555 | 7/8/2022 4:56 PM |
Addresses | Shipping Address | Insert | New Registration | | RUHS - Surgical Center Pharmacy
26600 Cactus Ave
Moreno Valley, CA 92555 | 7/8/2022 4:56 PM |
Addresses | Shipping Address | Insert | New Registration | | RUHS - Corona Pharmacy
2813 South Main Street
Corona, CA 92882 | 7/8/2022 4:56 PM |
Addresses | Shipping Address | Insert | New Registration | | RUHS - Neighborhood Pharmacy
7140 Indiana Ave
Riverside, CA 92504 | 7/8/2022 4:56 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1386758225 | 7/8/2022 4:56 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | CA | 7/8/2022 4:56 PM |
Contacts | Primary Contact | Insert | New Registration | | Tidwell, Davalyn
Pharmacy Director
RUHS
9514864527 | 7/8/2022 4:56 PM |
Contacts | Authorizing Official | Insert | New Registration | | Patterson, Leah
Chief Nursing Officer
RUHS
9514867532 | 7/8/2022 4:56 PM |
Details | Assistance Received From Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Assistance Received To Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Last Recertification Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Grant Number | Insert | New Registration | | H80CS28990 | 7/8/2022 4:56 PM |
Details | 340B ID | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 7/8/2022 4:56 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Medicare Provider Number | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Entity Name | Insert | New Registration | | Riverside, County of | 7/8/2022 4:56 PM |
Details | NOFO Number | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | Program Code | Insert | New Registration | | CH | 7/8/2022 4:56 PM |
Details | Entity Subname | Insert | New Registration | | Palm Springs Community Health Center | 7/8/2022 4:56 PM |
Dates | Participating Approval Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Details | State | Insert | New Registration | | Pending | 7/8/2022 4:56 PM |
Dates | Registration Date | Insert | New Registration | | 7/8/2022 4:56:16 PM | 7/8/2022 4:56 PM |
Dates | Signed By Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Dates | Start Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Terminations | Termination Comments | Insert | New Registration | | | 7/8/2022 4:56 PM |
Terminations | Termination Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Terminations | Termination Effective Date | Insert | New Registration | | | 7/8/2022 4:56 PM |
Terminations | Termination Reason | Insert | New Registration | | | 7/8/2022 4:56 PM |